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Perioperative Complications and In-Hospital Mortality in Paraplegic Radical Cystectomy Patients
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Perioperative Complications and In-Hospital Mortality in Paraplegic Radical Cystectomy Patients
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Journal Article
Perioperative Complications and In-Hospital Mortality in Paraplegic Radical Cystectomy Patients
2025
Overview
Objective
The aim of this study was to test for the association between paraplegia and perioperative complications as well as in-hospital mortality after radical cystectomy (RC) for non-metastatic bladder cancer.
Methods
Perioperative complications and in-hospital mortality were tabulated in RC patients with or without paraplegia in the National Inpatient Sample (2000–2019).
Results
Of 25,527 RC patients, 185 (0.7%) were paraplegic. Paraplegic RC patients were younger (≤70 years of age; 75 vs. 53%), more frequently female (28 vs. 19%), and more frequently harbored Charlson Comorbidity Index ≥3 (56 vs. 18%). Of paraplegic vs. non-paraplegic RC patients, 141 versus 15,112 (76 vs. 60%) experienced overall complications, 38 versus 2794 (21 vs. 11%) pulmonary complications, 36 versus 3525 (19 vs. 14%) genitourinary complications, 33 versus 3087 (18 vs. 12%) intraoperative complications, 21 versus 1035 (11 vs. 4%) infections, and 17 versus 1343 (9 vs. 5%) wound complications, while 62 versus 6267 (34 vs. 25%) received blood transfusions, 47 versus 3044 (25 vs. 12%) received critical care therapy (CCT), and intrahospital mortality was recorded in 13 versus 456 (7.0 vs. 1.8%) patients. In multivariable logistic regression models, paraplegic status independently predicted higher overall CCT use (odds ratio [OR] 2.1,
p
< 0.001) as well as fourfold higher in-hospital mortality (
p
< 0.001), higher infection rate (OR 2.5,
p
< 0.001), higher blood transfusion rate (OR 1.45,
p
= 0.009), and higher intraoperative (OR 1.56,
p
= 0.02), wound (OR 1.89,
p
= 0.01), and pulmonary (OR 1.72,
p
= 0.004) complication rates.
Conclusion
Paraplegic patients contemplating RC should be counseled about fourfold higher risk of in-hospital mortality and higher rates of other untoward effects.
Publisher
Springer International Publishing,Springer Nature B.V
Subject
/ Cystectomy - adverse effects
/ Female
/ Humans
/ Intraoperative Complications - mortality
/ Male
/ Medicine
/ Oncology
/ Postoperative Complications - etiology
/ Postoperative Complications - mortality
/ Surgery
/ Urinary Bladder Neoplasms - complications
/ Urinary Bladder Neoplasms - mortality
/ Urinary Bladder Neoplasms - pathology
/ Urinary Bladder Neoplasms - surgery
/ Wounds
